| NPI | 1801249677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301109431) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5315075407) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2017-05-11 |