| NPI | 1740207752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME96994) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A88708) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2020-04-01 |