| NPI | 1730248493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA G84705) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 198408) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2025-05-15 |