| NPI | 1366426165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 6516) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 27423) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2023-03-03 |