| NPI | 1790972404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301095782) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA a101039) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2015-07-13 |