| NPI | 1508850843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C196767) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 232612-1) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2024-08-06 |