| NPI | 1598962391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 44772) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 259484) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2010-12-10 |