| NPI | 1245422435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A9568) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 20A9568) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2021-11-29 |