| NPI | 1700059615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A121646) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2008015973) |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2012-10-27 |