NPI | 1043325319 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CO DEN.00008879) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 8879) |
1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CO DEN.00008879) | |
Enumeration Date | 2006-08-20 |
Last Update Date | 2018-11-30 |