| NPI | 1407961840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 268290) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301083945) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2016-12-06 |