| NPI | 1235799867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A195226) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL82838) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2024-06-17 |