| NPI | 1538155072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 29078) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 29078) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2022-05-13 |