| NPI | 1790756153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 46747-20) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD08877) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2014-03-26 |