| NPI | 1740264944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 27819) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME61960) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2018-04-09 |