| NPI | 1639101314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX G7001) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX G7001) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2024-12-20 |