| NPI | 1316191208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 280919) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101251999) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2020-12-18 |