| NPI | 1770575839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 8903) |
| Additional Taxonomies | 174400000X Specialist (Licence: SC 10691) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2016-11-02 |