| NPI | 1609029750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A121024) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 250249-1) |
| Enumeration Date | 2008-11-02 |
| Last Update Date | 2023-02-16 |