| NPI | 1760450092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A79878) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101256511) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: VA 0101256511) | |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2021-12-17 |