| NPI | 1003159146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0066623) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102204110) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2021-06-22 |