| NPI | 1811957772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101231594) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2007-00679) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2016-07-22 |