| NPI | 1689670374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WY 9882A) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 9900328) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2015-07-13 |