| NPI | 1235472648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 137198) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A137198) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2018-03-17 |