| NPI | 1770639148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD176096) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA C134444) |
| 207L00000X Anesthesiology (Licence: NE 24015) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2016-04-06 |