| NPI | 1194014274 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A 144367)  | 
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA A 144367)  | 
| Enumeration Date | 2011-03-29 | 
| Last Update Date | 2022-03-29 |