| NPI | 1811230287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO CDR.0001575) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 59764) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2022-04-05 |