| NPI | 1639106800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A95842) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 40956) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2008-11-12 |