| NPI | 1962637892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301108718) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A124518) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2022-07-21 |