| NPI | 1235529694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C55777) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ MA67642) |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2015-01-23 |