| NPI | 1245353697 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A113661) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 24064) | 
| Enumeration Date | 2007-04-09 | 
| Last Update Date | 2022-01-07 |