| NPI | 1962638726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 47426) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0070210) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2026-08-06 |