| NPI | 1639494537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 137566) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 257891) |
| Enumeration Date | 2010-04-02 |
| Last Update Date | 2015-09-23 |