| NPI | 1710951223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 44916) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME97776) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2025-07-14 |