| NPI | 1871751529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 066861) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 228608) |
| 207L00000X Anesthesiology (Licence: NC 2010-00613) | |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2013-08-26 |