| NPI | 1578510418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 47240) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 17985) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2011-06-23 |