| NPI | 1982271300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 5151015075) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 5151015075) |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2022-06-27 |