| NPI | 1215978150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C166932) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD426256) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2019-12-03 |