| NPI | 1124146543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME98828) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 222053) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2025-02-12 |