| NPI | 1700896347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2010029896) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 1648811205) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2019-04-18 |