| NPI | 1932490919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 91627) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A123469) |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2022-11-18 |