| NPI | 1386756062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 55245) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 055245) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-03-14 |