| NPI | 1285632059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 241064-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 209688) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2009-11-18 |