| NPI | 1316110455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A119688) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 53787) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2016-10-03 |