| NPI | 1598745598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AL 00022035) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD27178) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2022-05-03 |