| NPI | 1871785014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD177739) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA pending) |
| Enumeration Date | 2007-08-12 |
| Last Update Date | 2018-10-11 |