| NPI | 1053335984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 42553) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301054992) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2009-08-05 |