| NPI | 1689875130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A116343) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 248075) |
| 207L00000X Anesthesiology (Licence: TN 52985) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2023-10-10 |