| NPI | 1942380506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 78800) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 207L00000X Anesthesiology (Licence: FL ME38787) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2024-07-31 |