| NPI | 1124024807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 205113) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0062283) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2020-09-01 |