| NPI | 1790758985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AR E7407) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 21664) |
| 207L00000X Anesthesiology (Licence: VA 0101242416) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2012-04-17 |