| NPI | 1710196654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0047575) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 25982) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2013-06-07 |