| NPI | 1508285909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WY 11718A) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0067337) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2023-03-04 |