| NPI | 1326085465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO R3C29) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO MDR329) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2023-06-28 |