| NPI | 1174055693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A182607) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD61505577) |
| 207L00000X Anesthesiology (Licence: WI 101829) | |
| 207L00000X Anesthesiology (Licence: CO DR.0065803) | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2024-10-15 |