| NPI | 1023305109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS13887) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101022877) |
| 207L00000X Anesthesiology (Licence: MI 5315078778) | |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2016-08-25 |