| NPI | 1922042803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301049141) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G67394) |
| 207L00000X Anesthesiology (Licence: NY 2368121) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2007-07-09 |