| NPI | 1760609846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA SP-189) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301089022) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2008-12-18 |