| NPI | 1720269699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 66280) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 0000046012) |
| 207L00000X Anesthesiology (Licence: NY 296382) | |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2023-03-29 |