| NPI | 1730347410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C146166) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0073708) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2021-12-07 |