| NPI | 1871753038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 49433) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 252430) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2021-06-29 |