| NPI | 1861682189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA MD.202012) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A112590) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2012-08-10 |