| NPI | 1780710145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A109608) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA L-227994) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2015-05-12 |