| NPI | 1528075793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 19091) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME92106) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2013-02-08 |