| NPI | 1245259894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 20539) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 334315-1205) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2018-10-02 |