| NPI | 1497962914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G072321) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 101796-875) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2024-05-29 |