| NPI | 1467537480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A50372) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A50372) |
| 207Q00000X Family Medicine (Licence: CA A50372) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2016-01-05 |