| NPI | 1831597491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME134462) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301104662) |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2018-03-17 |