| NPI | 1457719577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 312509) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A138288) |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2019-06-19 |