| NPI | 1013976745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A043896) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 34538) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2020-06-11 |