| NPI | 1649569591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 77893) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 264584) |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2023-07-11 |