| NPI | 1700029857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL TRN#12555) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA md41831) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: IA MD41831) | |
| Enumeration Date | 2009-04-18 |
| Last Update Date | 2014-09-21 |