| NPI | 1881655991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0059088) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME86771) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2014-09-24 |