| NPI | 1760803480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DC MD034913) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: DC MD034913) |
| Enumeration Date | 2013-12-23 |
| Last Update Date | 2013-12-23 |