| NPI | 1487916318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2014-01559) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 56235) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2024-09-23 |