| NPI | 1316149354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 67284) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL MD.28141) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2016-03-23 |