| NPI | 1558699827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A110128) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A 110128) |
| Enumeration Date | 2009-11-25 |
| Last Update Date | 2021-11-29 |