| NPI | 1730189614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C56304) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 207928) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2012-08-13 |