| NPI | 1770774036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A99853) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A99853) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2015-08-26 |