| NPI | 1518378454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0063716) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 201660) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2023-01-03 |