| NPI | 1467719054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0058743) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM MD2016-0252) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2026-09-03 |