| NPI | 1942296025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C54673) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 10784) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2016-08-24 |