| NPI | 1437641628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 1019921) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX T7638) |
| 208600000X Surgery (Licence: RI LP04300) | |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2024-11-10 |