| NPI | 1841461431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: UT 154834-1205) |
| Additional Taxonomies | 207LH0002X Anesthesiology Hospice and Palliative Medicine (Licence: UT 154834-1205) |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2024-09-30 |