| NPI | 1528101912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301091491) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 230939) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2019-10-22 |