| NPI | 1124557061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0065411) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-10980) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2021-07-29 |