| NPI | 1295149946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ R74630) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R74630) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2015-05-12 |