| NPI | 1154407146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 048602) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 238351-1) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2016-04-23 |