| NPI | 1912935305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G79262) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: HI 13687) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2008-10-21 |