| NPI | 1972037877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 6410) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX T0496) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2022-08-03 |