| NPI | 1194846063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 50952) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301084526) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2008-09-09 |