| NPI | 1639460074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101265893) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 280063) |
| 207L00000X Anesthesiology (Licence: CA A122347) | |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2022-08-31 |