| NPI | 1417323478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301106646) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301106646) |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2015-08-24 |