| NPI | 1689170789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 24049) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0068295) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2023-08-14 |