| NPI | 1043217789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME73875) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA MD022193) |
| 207L00000X Anesthesiology (Licence: MD D0056902) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2013-08-27 |