| NPI | 1912105586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A111767) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT191697) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2021-12-03 |