| NPI | 1285976357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A170446) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D83587) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MD D83587) | |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2021-03-23 |