| NPI | 1972568954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN DO2186) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 18129) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2011-02-22 |