| NPI | 1689807331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2014-00502) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT195929) |
| 207L00000X Anesthesiology (Licence: CA A118382) | |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2014-05-13 |