| NPI | 1952906497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 95001518) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 814779) |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2021-04-01 |