| NPI | 1821417767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0066056) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101263301) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2021-06-25 |