| NPI | 1871814558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD219539) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 129279) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2024-07-12 |