| NPI | 1407958283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 200400354) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS-007504L) |
| 207L00000X Anesthesiology (Licence: MD H0062671) | |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2009-10-24 |