| NPI | 1093767618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 25515) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: KY 25515) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2007-07-09 |