| NPI | 1669448940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A94154) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 224921) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 224921) | |
| 207L00000X Anesthesiology (Licence: GA 054992) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2022-02-11 |