| NPI | 1417972563 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 37796)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A76637)  | 
| Enumeration Date | 2006-07-12 | 
| Last Update Date | 2010-10-27 |