| NPI | 1831400266 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 006375) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL UO2439) | 
| Enumeration Date | 2010-06-30 | 
| Last Update Date | 2014-07-07 |