| NPI | 1427375088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD180854) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A131836) |
| 207L00000X Anesthesiology (Licence: UT 6233464-1205) | |
| Enumeration Date | 2010-04-22 |
| Last Update Date | 2017-02-10 |