| NPI | 1891775243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301084822) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 220729) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2010-03-17 |