| NPI | 1144584376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 59698) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301101588) |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2026-06-10 |