| NPI | 1972939296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301102019) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: MI 4301102019) |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2013-10-08 |