| NPI | 1033377114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 60100-20) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 149047) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2013-07-23 |