| NPI | 1730402017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101250834) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D81025) |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2026-04-21 |