| NPI | 1821294513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A108165) |
| Additional Taxonomies | 208600000X Surgery (Licence: HI MDR-5310) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2018-05-30 |