| NPI | 1316290521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-55105) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A119214) |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2025-06-04 |