| NPI | 1235101460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 247816) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD417632) |
| 207L00000X Anesthesiology (Licence: NY 0015787) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2021-03-04 |