| NPI | 1871732180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A10765) |
| Additional Taxonomies | 284300000X Special Hospital (Licence: CA A105765) |
| Enumeration Date | 2009-02-10 |
| Last Update Date | 2014-10-24 |