| NPI | 1538197660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD190142) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G36856) |
| 207L00000X Anesthesiology (Licence: CA G36856) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2023-03-07 |