| NPI | 1063739894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2014005675) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA Application active) |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2024-05-23 |