| NPI | 1952325698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A7333) |
| Additional Taxonomies | 207LA0401X Anesthesiology Addiction Medicine (Licence: TN 5119) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2024-01-25 |