| NPI | 1811911050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A112228) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH00039239) |
| 207L00000X Anesthesiology (Licence: OR MD155033) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2022-02-04 |