| NPI | 1235297904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL TRN8997) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: HI MD-15178) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2013-08-28 |