| NPI | 1083000913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A168791) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2019-00856) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2022-09-14 |