| NPI | 1710190376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301099309) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 235119) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2014-07-03 |