| NPI | 1245238690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 177042) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD429278) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2014-12-08 |