| NPI | 1710246996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 87194) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A165326) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2021-01-21 |