| NPI | 1760456768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: HI 1240) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 20A9039) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2022-02-11 |