| NPI | 1891223053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101277077) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A166553) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2022-11-07 |