| NPI | 1265879076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A190765) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A197110) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2024-08-08 |