| NPI | 1154435485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 40164) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 341005-1205) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2023-03-07 |