| NPI | 1134240682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 30510) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 001291) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: MD D0068610) | |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: NC 161837) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2017-10-31 |