| NPI | 1700236403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT MED-PHYS-LIC-83594) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 7668) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2020-07-09 |