| NPI | 1255399812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 36315) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 28371) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2024-01-16 |