| NPI | 1174663868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO CDRH.0054757) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D72052) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2023-11-08 |