| NPI | 1699934133 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A129751)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA L-236498)  | 
| Enumeration Date | 2008-06-09 | 
| Last Update Date | 2014-04-22 |