| NPI | 1225526510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS022245) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R2957) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2023-11-28 |