| NPI | 1891055505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 51358) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD P27665) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2016-10-20 |