| NPI | 1831366855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301090450) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301090450) |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2023-10-24 |