| NPI | 1518227560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301111679) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA L-251457) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2021-04-19 |