| NPI | 1366416331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS012576) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0060159) |
| 207L00000X Anesthesiology (Licence: WV 3358) | |
| 207L00000X Anesthesiology (Licence: TX M0461) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2025-03-31 |