| NPI | 1679956270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AL 41809) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL MD.41809) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2024-10-09 |