| NPI | 1992785067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301048530) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 26841) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2018-01-26 |