| NPI | 1669446316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME92594) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 057312) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2007-12-17 |