| NPI | 1134396179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: KY 45082) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 45082) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2017-07-27 |