| NPI | 1710025960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A36901) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: HI MD4636) |
| 207L00000X Anesthesiology (Licence: VA 0101249197) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2021-08-04 |