| NPI | 1841480977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301095799) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 51562-020) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2022-11-28 |