| NPI | 1760487052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G87798) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 187670) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2013-03-01 |