| NPI | 1366577918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS12553) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CA 20A9793) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2014-08-29 |