| NPI | 1407804370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: CA A84610) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A84610) |
| 207R00000X Internal Medicine (Licence: CA A84610) | |
| 207L00000X Anesthesiology (Licence: CA A84610) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2015-04-29 |