| NPI | 1700132693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA ML143309) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA ML 60285668) |
| Enumeration Date | 2012-07-28 |
| Last Update Date | 2021-12-06 |