| NPI | 1508846080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: MO 2013004546) |
| Additional Taxonomies | 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: KS 04-22336) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2022-10-06 |