| NPI | 1124264734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 051001) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN11645) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CT 051001) | |
| Enumeration Date | 2009-01-02 |
| Last Update Date | 2018-07-13 |