| NPI | 1083668222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 33519) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD424268) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: AZ 33519) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2022-11-30 |