| NPI | 1467747238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0055254) |
| Additional Taxonomies | 208600000X Surgery (Licence: HI MDR-6086) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2019-07-19 |