| NPI | 1043342124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 48174) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR LL16284) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CO DR.0048174) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2025-12-22 |