| NPI | 1700940780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR50234) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD437719) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CO DR50234) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2013-06-10 |