| NPI | 1194704627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 1916121) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD050938L) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2010-11-23 |