| NPI | 1770726978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 17102) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 256964) |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2015-08-06 |