| NPI | 1932581345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2015019886) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301504275) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2025-05-16 |