| NPI | 1679003818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 172663) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 271776) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2022-09-14 |