| NPI | 1235246471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A124377) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101240393) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2023-05-15 |