| NPI | 1639227200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 3336) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 20A4918) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2010-11-29 |