| NPI | 1114197621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 264645) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 6851260-1205) |
| 207L00000X Anesthesiology (Licence: GA 63855) | |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2016-05-24 |