| NPI | 1982061677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 6924) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 80214) |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2019-01-03 |