| NPI | 1154301232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301086609) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0061973) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2014-07-03 |