| NPI | 1538421987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 257716) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA L-251380) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2016-01-05 |