| NPI | 1841277712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 60874) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 31473) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2021-07-20 |