| NPI | 1902807050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MS 07755) |
| Additional Taxonomies | 174400000X Specialist (Licence: MS 07755) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2013-01-24 |