| NPI | 1194963116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 251896-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 262030) |
| Enumeration Date | 2009-01-29 |
| Last Update Date | 2015-04-30 |