| NPI | 1275762387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A130547) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301095024) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2014-06-10 |