| NPI | 1386730893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT 11721) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 25595) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: MT 11721) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2024-02-29 |