| NPI | 1902980766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 44926) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN6827) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2021-07-19 |