| NPI | 1184656993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 274384) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 73745) |
| 207L00000X Anesthesiology (Licence: MD D43681) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2014-12-02 |