| NPI | 1740529593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A149030) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 000000000) |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2023-01-04 |