| NPI | 1538384094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M6188) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX M6188) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2021-12-28 |