| NPI | 1710305693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 82239) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301114372) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2019-09-24 |