| NPI | 1215048301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME134344) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA07844000) |
| 207L00000X Anesthesiology (Licence: NY 214343-1) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-02-26 |