| NPI | 1457335051 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2022-01775) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 236448) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2025-02-07 |