| NPI | 1184601775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101246446) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME83859) |
| 207L00000X Anesthesiology (Licence: CT 55960) | |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2024-04-17 |