| NPI | 1790851236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A 9242) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A9242) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2010-06-30 |