| NPI | 1699090233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR DO190707) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 258859) |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2024-02-06 |