| NPI | 1487883062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NC 2013-00862) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2013-00862) |
| 207L00000X Anesthesiology (Licence: PA MD446260) | |
| Enumeration Date | 2009-07-05 |
| Last Update Date | 2019-12-04 |