| NPI | 1619955572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A102783) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 04-30630) |
| Enumeration Date | 2006-01-02 |
| Last Update Date | 2020-01-27 |