| NPI | 1740485663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 37409) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 232959) |
| 207L00000X Anesthesiology (Licence: NC 2012-00392) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2014-10-20 |