| NPI | 1114975364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 101455) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 155627) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2024-08-27 |