| NPI | 1770743403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 11238688-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A104930) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2019-06-22 |