| NPI | 1073809059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 26932) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 4770) |
| 207L00000X Anesthesiology (Licence: IA MD-42498) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2024-10-23 |