| NPI | 1487600250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME113870) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA C38755) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2017-03-02 |