| NPI | 1790705960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 018205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 018205) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2008-03-28 |