| NPI | 1881637973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 09339R) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 00025600) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2019-07-26 |