| NPI | 1790949121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2011-00627) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 43498) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2012-06-06 |