| NPI | 1902118185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 054665) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CT 054665) |
| 208600000X Surgery (Licence: MA 244403) | |
| Enumeration Date | 2010-07-05 |
| Last Update Date | 2016-06-07 |