| NPI | 1710012885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 16556) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 14803R) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2014-06-30 |