| NPI | 1700877313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A94323) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 233565-1) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2022-12-09 |