| NPI | 1821326927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 80091) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC MMD.35659LL) |
| Enumeration Date | 2009-12-01 |
| Last Update Date | 2018-10-17 |