| NPI | 1720313463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 042.0014177) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A110918) |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2018-09-13 |