| NPI | 1184621047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD431830) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0062147) |
| 207L00000X Anesthesiology (Licence: NY 249601) | |
| Enumeration Date | 2005-07-06 |
| Last Update Date | 2015-03-02 |