| NPI | 1114966025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 4586) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 20A8275) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2020-02-18 |