| NPI | 1396906723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD447850) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT193370) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2014-09-12 |