| NPI | 1356571343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME172947) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 0434267) |
| 207L00000X Anesthesiology (Licence: OK 25099) | |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2025-10-30 |