| NPI | 1306988019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C191676) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 49730) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WA MD 60217883) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA C191676) | |
| 208600000X Surgery (Licence: MN 49730) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2024-04-10 |