| NPI | 1780660027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME52251) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN MD0000027358) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2024-12-15 |