| NPI | 1053568287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC MMD.32582 TL) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN9254) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2010-06-03 |