| NPI | 1023571171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 285346) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY AU9053125-O03) |
| Enumeration Date | 2019-04-06 |
| Last Update Date | 2020-07-04 |