| NPI | 1003015728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 067920) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 67920) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2014-04-02 |