| NPI | 1124223565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A117430) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA 1124223565) |
| 208600000X Surgery (Licence: CA A117430) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CA A117430) | |
| Enumeration Date | 2007-06-16 |
| Last Update Date | 2019-12-23 |