| NPI | 1114993599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 135710) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 135710) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2014-12-19 |