| NPI | 1972528180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD187959) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A68493) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2018-10-17 |