NPI | 1104814904 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 040727) |
Additional Taxonomies | 174400000X Specialist (Licence: CT 040727) |
Enumeration Date | 2005-10-06 |
Last Update Date | 2013-10-20 |