| NPI | 1366428930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 7348) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD61451194) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2024-06-12 |