| NPI | 1962436055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 40425) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 40425) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2012-06-25 |