| NPI | 1821078528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301060430) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: MI 4301060430) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2007-08-14 |