| NPI | 1184865404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A95687) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: CA A95687) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A95687) | |
| 208D00000X General Practice (Licence: CA A95687) | |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2013-05-29 |