| NPI | 1912971466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101280127) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 31601) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2024-01-20 |