| NPI | 1972745370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A112820) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT191429) |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2019-01-29 |