| NPI | 1760463442 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 42198)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A82307)  | 
| Enumeration Date | 2005-11-09 | 
| Last Update Date | 2015-06-30 |