| NPI | 1699745489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 40643) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA C54078) |
| 207L00000X Anesthesiology (Licence: WI 1376) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2021-07-09 |