| NPI | 1588009286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 20251) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101256778) |
| 207L00000X Anesthesiology (Licence: AZ 62619) | |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2023-11-13 |