| NPI | 1124005244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C52714) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 35338) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2021-10-01 |