| NPI | 1922393826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 0055349) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO 4052) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2021-06-18 |