| NPI | 1558305573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301033588) |
| Additional Taxonomies | 174400000X Specialist (Licence: 4301033588) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2012-09-24 |