| NPI | 1942201355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL 96091) |
| Additional Taxonomies | 174400000X Specialist (Licence: NH NH10428) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2014-04-24 |