| NPI | 1033191960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 27689) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01038598A) |
| 207L00000X Anesthesiology (Licence: FL ME80728) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2017-02-21 |