| NPI | 1629059811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM MD2020-0581) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 39134) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2023-11-14 |