| NPI | 1205193067 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM MD2022-0385) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL MD.34266) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2025-01-28 |