| NPI | 1922054618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 00702) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 053930) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2023-05-20 |