| NPI | 1043244809 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 231861)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0057200)  | 
| 207L00000X Anesthesiology (Licence: MA 270166)  | |
| 207L00000X Anesthesiology (Licence: FL ME90345)  | |
| 207L00000X Anesthesiology (Licence: CT 61871)  | |
| Enumeration Date | 2006-07-10 | 
| Last Update Date | 2024-08-26 |