| NPI | 1952539470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0067155) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 25910) |
| 208D00000X General Practice (Licence: NE 25910) | |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2022-10-11 |