| NPI | 1760686463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL WE160627) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 24725) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2024-04-09 |