| NPI | 1063830271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A16161) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 65307-21) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2018-08-24 |