| NPI | 1972704070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS10592) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101015979) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2009-11-16 |