| NPI | 1073975884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: AZ 67133) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: VA 0101272281) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2022-08-31 |