| NPI | 1982846325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A12489) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX P4702) |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2021-07-28 |