| NPI | 1407017247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0063084) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA C158978) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2019-09-18 |