| NPI | 1275520801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 038076) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 192793-1) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2010-07-26 |