| NPI | 1225159668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 245665) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA L-222914) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2009-11-06 |