| NPI | 1598786055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G65170) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: CA G65170) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2022-02-01 |