| NPI | 1972772382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 047575) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 229169) |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2015-04-07 |