| NPI | 1982632766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX J3763) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301077230) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2018-06-05 |