| NPI | 1316147515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C158917) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME109792) |
| 207L00000X Anesthesiology (Licence: NC 200700627) | |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2021-12-17 |