| NPI | 1659436913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NE 1324) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT 9764) |
| 207L00000X Anesthesiology (Licence: NE 1324) | |
| 207L00000X Anesthesiology (Licence: NC 230174) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2022-03-25 |