| NPI | 1922401025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA A166693) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP449135) |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2021-02-04 |