| NPI | 1831396779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA A111224) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 228552) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2021-12-02 |