| NPI | 1184882789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 81569) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC TL30811) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2023-04-19 |