| NPI | 1457721516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A19166) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 007034) |
| 208D00000X General Practice (Licence: AZ 007034) | |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2023-03-27 |