| NPI | 1285821645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ND 11879) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A96769) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2015-01-15 |