| NPI | 1821006669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 20-35380) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 036713) |
| 207L00000X Anesthesiology (Licence: AL 15311) | |
| 207L00000X Anesthesiology (Licence: NC 2012-2332) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2015-04-01 |