| NPI | 1710365044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0069450) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 299386-1) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2022-10-17 |