| NPI | 1295749695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD158172) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G54203) |
| 207L00000X Anesthesiology (Licence: NV 5549) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2017-11-03 |