| NPI | 1740248566 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 55247) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 40900-020) | 
| Enumeration Date | 2006-05-02 | 
| Last Update Date | 2021-11-29 |