| NPI | 1104986447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AR E-9845) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME 95343) |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2020-09-21 |