| NPI | 1346774924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM RS2021-0130) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD481853) |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2023-10-16 |