| NPI | 1407827645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2017-00168) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A93363) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2021-02-25 |