| NPI | 1750592739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A119009) |
| Additional Taxonomies | 208VP0000X (Licence: WI 72747) |
| 207L00000X Anesthesiology (Licence: WI 72747) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2023-01-05 |