| NPI | 1720152234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 56220) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301074757) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2018-02-08 |