| NPI | 1184845026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2010-01330) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT 102030) |
| 207L00000X Anesthesiology (Licence: NE 5487) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2024-05-23 |