| NPI | 1790886638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101255820) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A 109052) |
| 207L00000X Anesthesiology (Licence: NC 200300981) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2024-01-20 |