| NPI | 1871701672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A 10761) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0102201964) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2019-12-10 |