| NPI | 1447407432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO CDRH.0051745) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD159768) |
| 207L00000X Anesthesiology (Licence: WA MD60294456) | |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2025-05-28 |