| NPI | 1538237672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2012-00111) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN9928) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2012-03-13 |