| NPI | 1336473453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 25597) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: NV 25597) |
| 2086S0102X Surgery Surgical Critical Care (Licence: PA MD438040) | |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2024-08-30 |