| NPI | 1730391988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME 38704) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD24816) |
| 207L00000X Anesthesiology (Licence: TN MD0000037800) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-07-08 |