| NPI | 1184906638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 39758) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 279747-1) |
| Enumeration Date | 2011-09-11 |
| Last Update Date | 2016-06-15 |