| NPI | 1558348193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ND 4989) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 36151) |
| Enumeration Date | 2005-12-26 |
| Last Update Date | 2017-04-26 |