| NPI | 1285680983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 71885) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 281865) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 71885) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2015-10-08 |