| NPI | 1861513509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 37144) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5315252047) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2024-10-10 |