| NPI | 1235525882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 83021) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A183519) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2023-08-10 |