| NPI | 1588640460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA 34467) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0069589) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2023-07-20 |