| NPI | 1124262787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A9294) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A9294) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2009-09-28 |