| NPI | 1407140395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0056115) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 55531) |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2018-09-10 |