| NPI | 1427121318 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A8401)  | 
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CA 20A8401)  | 
| Enumeration Date | 2006-11-16 | 
| Last Update Date | 2017-04-07 |