| NPI | 1922195346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: KY 39878) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 39878) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2013-03-18 |