| NPI | 1134108244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 240357-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 44804) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2008-09-16 |