| NPI | 1376522847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME0067561) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA g79978a) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2021-11-29 |