| NPI | 1134388861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301097399) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 54215) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2015-07-02 |