| NPI | 1801877766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A96785) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 223767) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2013-03-18 |