| NPI | 1174731004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A116949) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2007016507) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2021-10-21 |