| NPI | 1588996029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A13226) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 253978) |
| Enumeration Date | 2010-02-09 |
| Last Update Date | 2014-06-03 |