| NPI | 1871505768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101022389) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: VA 0101022389) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2007-07-08 |