| NPI | 1750350153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX k3856) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD046974L) |
| 207L00000X Anesthesiology (Licence: FL ME123367) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2022-07-21 |