| NPI | 1992063960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-43182) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-9376) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2016-06-21 |