| NPI | 1396150058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A166405) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R74573) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2020-09-11 |