| NPI | 1841222569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0066676) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R10728) |
| 111N00000X Chiropractor (Licence: WI 3736-012) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2023-04-10 |