| NPI | 1073787800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A124967) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A124967) | |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2016-10-05 |