| NPI | 1114947504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MS 20698) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G87702) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2014-01-27 |