| NPI | 1124067731 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 49664)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A67540)  | 
| Enumeration Date | 2006-06-06 | 
| Last Update Date | 2018-09-26 |