| NPI | 1962670372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS14197) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX M8824) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2019-04-04 |