| NPI | 1811163751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 249690) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 233228) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2012-04-10 |