| NPI | 1891072070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A150520) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA CA 64932) |
| 207L00000X Anesthesiology (Licence: CA 150520) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2021-11-18 |