| NPI | 1982691515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA 25902) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 246601) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2011-03-04 |