| NPI | 1235173204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101269832) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 042-0008638) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2023-10-24 |