| NPI | 1760400253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G88290) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301064338) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2014-05-02 |