| NPI | 1508063314 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 60393) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A105704) | 
| 207L00000X Anesthesiology (Licence: IL 036120178) | |
| 207L00000X Anesthesiology (Licence: WI 53084) | |
| Enumeration Date | 2007-06-27 | 
| Last Update Date | 2021-10-01 |