| NPI | 1083124929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 84209) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 009677) |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2025-01-14 |