| NPI | 1386672632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A87478) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 057463) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2011-03-11 |