| NPI | 1770739385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 45801) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0058994) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2017-07-19 |