| NPI | 1437785524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 295382) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ZZ 00000000) |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2023-01-04 |