| NPI | 1104806546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301078033) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MI 4301078033) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2018-11-20 |