| NPI | 1790945509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A107524) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY p56560) |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2021-12-02 |