| NPI | 1659334274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME110447) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01039631) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2012-01-10 |