| NPI | 1609024082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301104433) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 237361) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2014-05-08 |