| NPI | 1770698946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 058246) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 284984-1205) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2013-03-13 |