| NPI | 1841790417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2023-02816) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101268156) |
| 207L00000X Anesthesiology (Licence: PA MD486526) | |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2025-06-04 |