| NPI | 1760553812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C55462) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ND 8996) |
| Enumeration Date | 2006-11-12 |
| Last Update Date | 2023-06-15 |