| NPI | 1578906665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A156562) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD463943) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2020-04-08 |