| NPI | 1649476953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2012003314) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301089880) |
| Enumeration Date | 2007-06-23 |
| Last Update Date | 2013-02-15 |