| NPI | 1174819916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 054703) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 279279) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2015-12-31 |