| NPI | 1619956034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 20838) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: AZ 20838) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2022-11-30 |