| NPI | 1730117987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00028233) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G64397) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2021-04-30 |