| NPI | 1033347455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101255608) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0075395) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2014-07-29 |