| NPI | 1538149778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2010000744) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 3086) |
| 207L00000X Anesthesiology (Licence: CO DR-34380) | |
| Enumeration Date | 2006-01-21 |
| Last Update Date | 2026-04-10 |