| NPI | 1366549602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G081857) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 246549) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2009-04-10 |