| NPI | 1275867541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 242302) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD437743) |
| Enumeration Date | 2009-09-19 |
| Last Update Date | 2012-03-30 |