| NPI | 1447577952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A12384) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 256441) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2021-03-05 |