| NPI | 1184129165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 32482) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 23681) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2023-08-07 |