| NPI | 1306881008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0057072) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101264972) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2024-02-09 |