| NPI | 1851365134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G73116) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 78794) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2008-08-09 |