| NPI | 1164429536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 35286) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 5331) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2021-04-28 |