| NPI | 1184351355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA PTL12625) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA PTL12625) |
| Enumeration Date | 2022-08-06 |
| Last Update Date | 2024-08-31 |