| NPI | 1881839900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AL 32319) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY R1997) |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2014-04-23 |