| NPI | 1760417950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 0050698) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: HI 14752) |
| 207L00000X Anesthesiology (Licence: CA A73848) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2024-09-16 |