| NPI | 1700967098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G79062) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G79062) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2016-05-09 |