| NPI | 1205299633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 303616) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 6425-851) |
| Enumeration Date | 2016-04-02 |
| Last Update Date | 2021-08-02 |