| NPI | 1710964804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 32576) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: CO 32576) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2013-04-18 |