| NPI | 1407234941 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A165293) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV A165293) | 
| Enumeration Date | 2015-05-18 | 
| Last Update Date | 2021-09-02 |