| NPI | 1578798203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301105022) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT195336) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2014-12-10 |