| NPI | 1770900177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A155431) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 299028) |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2023-07-03 |