| NPI | 1316923071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0040992) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D63099) |
| 207L00000X Anesthesiology (Licence: KY 57487) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2023-12-04 |