| NPI | 1679739858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2016-01176) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 51885) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2023-02-06 |