| NPI | 1598194847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 54529) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301106947) |
| 207L00000X Anesthesiology (Licence: SC 84491) | |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2024-01-17 |