| NPI | 1417198151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2017042148) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DC MD038147) |
| Enumeration Date | 2009-03-10 |
| Last Update Date | 2018-08-27 |