| NPI | 1104452036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301512279) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO CDR.0005761) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2025-10-29 |