| NPI | 1487021648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301107878) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI L799150) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-10-01 |