| NPI | 1003890385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 038550) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 217353) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2008-08-05 |