| NPI | 1578501813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 37184) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 33283) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2018-03-17 |