| NPI | 1619061058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A75678) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 15706) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2022-09-16 |