| NPI | 1063464493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 201774) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 201774-1) |
| 208600000X Surgery (Licence: NY 201774) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2015-04-27 |