| NPI | 1437387891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 30238) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2009013979) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2021-03-11 |