| NPI | 1669799110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A135166) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM MD2013-0062) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2018-08-01 |