| NPI | 1093248353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A171158) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 330070) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2024-06-27 |