| NPI | 1225021314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A44735) |
| Additional Taxonomies | 174400000X Specialist (Licence: HI 9025) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2013-09-12 |