| NPI | 1003844283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA MD015680) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 015680) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2014-12-29 |