| NPI | 1033646997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD209999) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 40921) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2024-08-05 |