| NPI | 1760986913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 286634) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: GA 96337) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2023-08-31 |