| NPI | 1457322711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2014-00667) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0047275) |
| 207L00000X Anesthesiology (Licence: AZ 22626) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2021-07-21 |