| NPI | 1063696268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 046585) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 203521) |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2011-03-14 |