| NPI | 1871904847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0070295) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101021244) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2023-10-17 |