| NPI | 1750403770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101254629) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301081603) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2013-09-20 |