| NPI | 1134351893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 268706) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.056061) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2023-03-13 |