| NPI | 1871797662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: HI 14926) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME101233) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2013-12-24 |