| NPI | 1902843535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G76267) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA G76267) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA G76267) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2019-09-30 |