| NPI | 1013247626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME119553) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301096370) |
| Enumeration Date | 2010-01-04 |
| Last Update Date | 2018-01-10 |