| NPI | 1538155759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 8739) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 25188) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2017-12-31 |