| NPI | 1568716959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AL 36974) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 81564) |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2023-08-23 |