| NPI | 1265852461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A171761) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 9529173-1205) |
| Enumeration Date | 2014-04-26 |
| Last Update Date | 2021-11-12 |