| NPI | 1154632065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 262793) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 244590) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2024-11-06 |