| NPI | 1063448157 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 187999-1)  | 
| Additional Taxonomies | 174400000X Specialist (Licence: NY 187999-1)  | 
| Enumeration Date | 2006-06-23 | 
| Last Update Date | 2010-11-23 |