| NPI | 1649345364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME111882) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN7885) |
| 207L00000X Anesthesiology (Licence: MI 4301091202) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2012-07-24 |