| NPI | 1245206861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD066184L) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 230264-1) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2011-09-16 |