| NPI | 1164451555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 156229-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME78580) |
| 207L00000X Anesthesiology (Licence: NC 200000933) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2017-12-11 |