| NPI | 1184695660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 9500830) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA L013195) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2016-09-10 |