| NPI | 1770554933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A77800) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 37501) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2014-12-10 |