| NPI | 1407250616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A139949) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 23032) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2023-08-03 |