| NPI | 1679543474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 47845) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M1651) |
| 208600000X Surgery (Licence: TX M1651) | |
| 207L00000X Anesthesiology (Licence: MO 2006010375) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2010-06-10 |