NPI | 1154783637 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 308564) |
Additional Taxonomies | 282N00000X General Acute Care Hospital |
Enumeration Date | 2016-03-24 |
Last Update Date | 2021-05-20 |