| NPI | 1881981447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 50856) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2024007991) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2025-05-23 |