| NPI | 1477996262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 32644) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 306582) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2018-10-26 |