| NPI | 1902889454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 44326) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A85130) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2019-12-20 |