| NPI | 1871804369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT 51315) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A137915) |
| 207T00000X Neurological Surgery (Licence: NM RS2010-331) | |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2020-09-09 |