| NPI | 1962478107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A66108) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: CA A66108) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2023-09-14 |