| NPI | 1386608594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0039824) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD417178) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2009-12-15 |