| NPI | 1518318294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0063678) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 7775) |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2020-05-21 |