| NPI | 1265432405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 160288) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME120679) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2019-11-19 |