| NPI | 1326498999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SD 12829) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY R4455) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2023-02-02 |