| NPI | 1295889129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C134911) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301074669) |
| 207L00000X Anesthesiology (Licence: CT 042893) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-08-25 |