| NPI | 1255430161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WY 14820A) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA g80229) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2023-09-11 |