| NPI | 1952682890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A133783) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA F5662) |
| 207L00000X Anesthesiology (Licence: MA 280126) | |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2022-03-14 |