| NPI | 1114185758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 47786) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A104108) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2019-12-16 |