| NPI | 1942424122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 1099) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA TMP 001009) |
| 207L00000X Anesthesiology (Licence: NC 2009-01131) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2015-07-17 |