| NPI | 1265691315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: GA 82758) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 82758) |
| 207L00000X Anesthesiology (Licence: NY 270912) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 270912) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A126778) | |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2019-09-23 |