| NPI | 1982798591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IA 38055) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME 013133) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2009-07-21 |