| NPI | 1114177664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 44415) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2008015177) |
| Enumeration Date | 2008-09-21 |
| Last Update Date | 2012-03-29 |