| NPI | 1740258300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME119864) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 10500) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2019-03-27 |