| NPI | 1306896485 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A8356)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS013288)  | 
| Enumeration Date | 2006-05-11 | 
| Last Update Date | 2021-12-13 |