| NPI | 1447632112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 157274) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT210527) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2022-09-07 |