| NPI | 1689907867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 62255) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301094764) |
| Enumeration Date | 2009-09-06 |
| Last Update Date | 2014-06-20 |