| NPI | 1336227255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO dr0052046) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0102201894) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2013-07-30 |