| NPI | 1316102205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 168963) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 251411) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2021-11-03 |