| NPI | 1164984209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS023591) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 4051) |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2024-06-16 |