| NPI | 1093007825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX p4098) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX p4098) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX P4098) | |
| 208D00000X General Practice (Licence: TX P4098) | |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2022-01-13 |