| NPI | 1477900157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: VA 0101271713) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10057588) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2021-07-29 |