| NPI | 1477507739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 974) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2005-01619) |
| 207L00000X Anesthesiology (Licence: MI 5101014673) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2014-11-24 |