| NPI | 1174834808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2014-02044) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2010019839) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2021-04-01 |