| NPI | 1073698536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301074733) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301074733) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2011-03-17 |