| NPI | 1467659441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 48879) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2007013989) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2010-08-20 |