| NPI | 1366823924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PR 22592) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PR 32408) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2022-08-19 |