| NPI | 1083029011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0062308) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 30797) |
| Enumeration Date | 2014-06-28 |
| Last Update Date | 2022-04-13 |