| NPI | 1013153972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 14352) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 14352) |
| Enumeration Date | 2008-12-26 |
| Last Update Date | 2008-12-26 |