| NPI | 1871809616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA SP209) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2010-00340) |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2011-12-12 |