| NPI | 1497987978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A117240) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA not yet) |
| 207L00000X Anesthesiology (Licence: MO 2017015075) | |
| Enumeration Date | 2009-08-17 |
| Last Update Date | 2022-09-28 |