| NPI | 1063868024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 18365) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 009049) |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2021-09-03 |