| NPI | 1366426678 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA 28442)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G48871)  | 
| Enumeration Date | 2005-11-30 | 
| Last Update Date | 2015-10-23 |