| NPI | 1154328730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 222926) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 51219) |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2022-03-22 |