| NPI | 1295905669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101253817) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME 017717) |
| Enumeration Date | 2008-03-02 |
| Last Update Date | 2014-02-21 |