| NPI | 1760723035 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV DO2875)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 20A15532)  | 
| Enumeration Date | 2013-03-11 | 
| Last Update Date | 2021-05-14 |