| NPI | 1972731024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM MD2013-0555) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM 207L00000X) |
| Enumeration Date | 2009-06-28 |
| Last Update Date | 2022-02-04 |