| NPI | 1639106008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0102201443) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 2406) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2015-02-25 |