| NPI | 1477782282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS11280) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101017967) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2011-05-26 |