| NPI | 1740251230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2016-00802) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0051131) |
| 207L00000X Anesthesiology (Licence: GA 50566) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2025-08-22 |