| NPI | 1952956757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0072609) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA 60967373) |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2025-02-10 |