| NPI | 1669735064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C178020) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD461159) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2022-10-14 |