| NPI | 1457563579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD28044) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301081388) |
| 207L00000X Anesthesiology (Licence: CO DR.0052027) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2013-02-11 |