| NPI | 1649476029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 26694) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 8231220-1205) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2015-11-12 |