| NPI | 1861752198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ AU2903599) |
| Additional Taxonomies | 174400000X Specialist (Licence: NV SL0891) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2022-11-17 |