| NPI | 1689611535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 9500977) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101233781) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2007-07-09 |