| NPI | 1063455152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 166982-1) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 1669821) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2009-10-06 |