| NPI | 1548498959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 24589) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 206905) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2026-07-20 |