| NPI | 1669407920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ME 015620) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301095748) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2012-02-08 |