| NPI | 1093730558 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 17568) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: HI MD13611) | 
| Enumeration Date | 2006-07-13 | 
| Last Update Date | 2018-07-05 |