| NPI | 1245425651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR0052048) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA os014232) |
| 207R00000X Internal Medicine (Licence: PA OTO11586) | |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2024-03-28 |