| NPI | 1922102268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 25609) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WY 6802A) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2014-08-22 |