| NPI | 1821068016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 249692) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0037671) |
| 207L00000X Anesthesiology (Licence: AZ 29325) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2026-02-06 |