| NPI | 1205985249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A98130) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 234470-1) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2008-08-04 |