| NPI | 1962577304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 9757) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 43041) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2023-03-13 |