| NPI | 1447412101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301092522) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301092522) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2014-07-03 |