| NPI | 1811122468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 35564) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2011-00989) |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2014-04-18 |