| NPI | 1922567171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 336498) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 312830) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2023-06-07 |