| NPI | 1083810089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 1477) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 20A10467) |
| 207L00000X Anesthesiology (Licence: MO 2005017809) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2019-10-17 |