| NPI | 1912135971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 49894) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301094337) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2013-08-26 |