| NPI | 1437356193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 53508) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MDR-5299) |
| 207L00000X Anesthesiology (Licence: UT 7087070-1205) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2014-05-27 |