| NPI | 1588984082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301106854) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT197023) |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2015-07-21 |