| NPI | 1508216995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A18839) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 10514829-1204) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2024-04-09 |