| NPI | 1144636770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0059948) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CO DR.0059948) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2018-08-31 |