| NPI | 1568448256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G159600) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 30535) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2019-05-31 |