| NPI | 1316258353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 257582) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA L-243200) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2015-07-16 |