| NPI | 1730133489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 35565) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 35565) |
| 207L00000X Anesthesiology (Licence: CO 43224) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2025-01-28 |