| NPI | 1154513976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 27319) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WY 7797A) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2014-11-10 |