| NPI | 1962687939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 41440) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 001386) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2010-10-27 |