| NPI | 1043598857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 42753) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME141132) |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2025-02-04 |