| NPI | 1720548399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A22343) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 321845) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2024-08-09 |