| NPI | 1417155474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS11139) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101017229) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2021-12-29 |