| NPI | 1720311921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ND 12794) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301094509) |
| Enumeration Date | 2009-09-07 |
| Last Update Date | 2013-07-12 |