| NPI | 1235349101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 48002) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A97624) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2010-04-09 |