| NPI | 1679140867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 105140) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 12878) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2025-07-28 |