| NPI | 1346631066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 208D00000X) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 009111) |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2021-07-19 |