| NPI | 1265492821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G85417) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0056231) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2017-06-27 |