| NPI | 1093805608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD471709) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 5221433-1205) |
| 207L00000X Anesthesiology (Licence: NY 150475) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-05-19 |