| NPI | 1043279821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 222087) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD456550) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2020-07-17 |