| NPI | 1205215472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 292712) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME123679) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2019-03-11 |