| NPI | 1295020089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA C171227) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: VA 0101266038) | |
| 207L00000X Anesthesiology (Licence: CA C171227) | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2024-03-09 |