| NPI | 1194935767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0102202196) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101015996) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2008-09-17 |