| NPI | 1427165877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 55739) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D74082) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: VA 0101240363) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2022-07-21 |