| NPI | 1982967535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS21630) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX Q8947) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2025-02-10 |