| NPI | 1447781901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 179493) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 301307) |
| Enumeration Date | 2017-03-25 |
| Last Update Date | 2023-01-06 |