| NPI | 1831147271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0053120) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2000154581) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2019-12-11 |