| NPI | 1548239601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G59385) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G59385) |
| 207Q00000X Family Medicine (Licence: CA G59385) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA G59385) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2007-07-08 |