| NPI | 1568677573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A98699) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 43612) |
| Enumeration Date | 2007-05-12 |
| Last Update Date | 2022-02-11 |