| NPI | 1609856574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301087201) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 19997) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2007-07-08 |