| NPI | 1831417963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301097241) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MI 4301097241) |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2015-07-30 |