| NPI | 1760802144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A164170) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60776026) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2019-10-08 |