| NPI | 1821309162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301104481) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2010021908) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2019-04-18 |