| NPI | 1811284706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS12756) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2011012268) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2016-03-16 |