| NPI | 1265852826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 207L00000X) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA 14425) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2021-11-01 |