| NPI | 1902987522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA g70640) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT 59579) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2025-01-17 |