| NPI | 1942393319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC AL32307) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101055163) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101055163) | |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2010-01-04 |