| NPI | 1700868783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 34993) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 223511) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 223511) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2010-10-27 |