| NPI | 1750370532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 228019) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA 070422) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2013-04-25 |