| NPI | 1992948947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2013011934) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 04-36266) |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2014-09-08 |