| NPI | 1336593839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2022-01044) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 21104) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2023-05-22 |