| NPI | 1225003254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 209401) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 2094011) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2021-03-04 |