| NPI | 1548299001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 025623) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA MD025623) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2019-10-31 |