| NPI | 1295931657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60522849) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301089679) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2015-07-15 |