| NPI | 1780692095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C55198) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 39679) |
| 207L00000X Anesthesiology (Licence: GU M-1953) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2017-12-17 |