| NPI | 1124518592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A181549) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: CA A177645) |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2023-10-25 |