| NPI | 1639284516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 7946266-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA ML20008516) |
| 207L00000X Anesthesiology (Licence: MA 243378) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2011-10-27 |