| NPI | 1629066253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0043360) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA 00048821) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2013-06-07 |