| NPI | 1699090480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 074476) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 56806) |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2018-05-14 |