| NPI | 1497778054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS18532) |
| Additional Taxonomies | 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: OH 34.005429) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2023-03-28 |