| NPI | 1912171539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 43460) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 43460) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2009-08-21 |