| NPI | 1184607368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA g83700) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA g83700) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2018-03-17 |