| NPI | 1477059103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61437072) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A165231) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2023-09-01 |