| NPI | 1568612729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 11878068-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A107102) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2021-10-25 |