| NPI | 1306941398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 33971) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME46931) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2019-12-16 |