| NPI | 1316208911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A155978) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 945261) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2025-08-15 |