| NPI | 1588874788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ND 11170) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301086186) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2012-05-02 |