| NPI | 1588783583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C137369) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 23904) |
| 207L00000X Anesthesiology (Licence: HI MD15492) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2022-09-13 |