| NPI | 1932109329 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 10624) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 211081) | 
| Enumeration Date | 2005-07-28 | 
| Last Update Date | 2016-09-14 |