| NPI | 1386894640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MD D0018856) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MD D0018856) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2008-09-23 |