| NPI | 1750423919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 43796) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 16454) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2008-10-22 |