| NPI | 1003025362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 5101019121) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 204105) |
| 207L00000X Anesthesiology (Licence: MA 228536) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2012-02-22 |