| NPI | 1871523142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G74795) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA04991600) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2007-07-08 |