| NPI | 1588758189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2006038824) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 32506) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2013-03-12 |