| NPI | 1720245830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A107891) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 244103) |
| Enumeration Date | 2008-05-18 |
| Last Update Date | 2018-10-22 |