| NPI | 1275830234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A13842) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 52804) |
| Enumeration Date | 2011-02-26 |
| Last Update Date | 2017-01-26 |