| NPI | 1376741900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA 39573) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R8183) |
| 207L00000X Anesthesiology (Licence: MI 4301100846) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2014-06-12 |