| NPI | 1306842380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 1798801) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 179380-1) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2015-01-24 |