| NPI | 1023320900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS17436) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101020842) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2021-01-29 |