| NPI | 1679876353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2009018186) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 03376) |
| Enumeration Date | 2010-12-17 |
| Last Update Date | 2012-06-12 |