| NPI | 1396057832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A153603) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0053117) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2019-06-28 |