| NPI | 1790714194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101056677) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME75821) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2008-06-19 |