| NPI | 1649251083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C170661) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME86152) |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2020-11-25 |