| NPI | 1396764627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 21451) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM 79-115) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2010-03-09 |