| NPI | 1609309475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA 20A20013) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0102205389) |
| 208D00000X General Practice (Licence: VA 0102205389) | |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2023-04-11 |