| NPI | 1386809440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV DO3686) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA op60020990) |
| 207L00000X Anesthesiology (Licence: CA 20A12359) | |
| 207L00000X Anesthesiology (Licence: CT 047459) | |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2024-08-30 |