| NPI | 1356616619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: CA 163250) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: NY 288790) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2020-04-15 |