| NPI | 1679514905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TX j6681) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX J6681) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2024-08-02 |