| NPI | 1376957381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: CO DR.0062061) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2014018054) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2019-08-27 |