| NPI | 1649257015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A88230) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: CA A88230) |
| 208D00000X General Practice (Licence: CA A88230) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A88230) | |
| 207L00000X Anesthesiology (Licence: FL ME 120727) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2022-02-11 |