| NPI | 1578636890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A89325) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 232312-1) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2022-07-07 |