| NPI | 1952509556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101244439) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 650L) |
| 207L00000X Anesthesiology (Licence: TN MD000004437) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2015-07-02 |