| NPI | 1588867162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT Temp) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0053341) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2024-09-26 |