| NPI | 1497378061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ND R49175) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 128430) |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2020-08-05 |